Provider Demographics
NPI:1194421784
Name:COMPREHENSIVE DENTAL CLINIC PC
Entity type:Organization
Organization Name:COMPREHENSIVE DENTAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:OJHA
Authorized Official - Suffix:
Authorized Official - Credentials:BDS MS FACP
Authorized Official - Phone:586-883-9521
Mailing Address - Street 1:2295 METROPOLITAN PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4293
Mailing Address - Country:US
Mailing Address - Phone:586-883-9521
Mailing Address - Fax:586-722-7478
Practice Address - Street 1:2295 METROPOLITAN PKWY STE 120
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4293
Practice Address - Country:US
Practice Address - Phone:586-883-9521
Practice Address - Fax:586-722-7478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty